Fri Nov 18 2022

41 articles - From Friday Nov 11 2022 to Friday Nov 18 2022

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…


Meta-analysis

meta-analyses and systematic reviews

Am J Kidney Dis

Cardiac and Kidney Adverse Effects of HIF Prolyl-Hydroxylase Inhibitors for Anemia in Patients With CKD Not Receiving Dialysis: A Systematic Review and Meta-analysis.

The occurrence of cardiac or kidney-related adverse events in the HIF-PHI groups were not different compared with placebo or ESA groups. Registered at PROSPERO with record number CRD42021228243.

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Clin Kidney J

Machine learning models for predicting acute kidney injury: a systematic review and critical appraisal.

Flexible ML methods are popular for the prediction of AKI, although more complex models based on deep learning are emerging. Our critical appraisal identified a high risk of bias in most models Studies should use calibration measures and external validation more often, improve model interpretability, and share data and code to improve reproducibility.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Am J Kidney Dis

Antimicrobial Photodynamic Therapy in the Nasal Decolonization of Maintenance Hemodialysis Patients: A Pilot Randomized Trial.

Photodynamic therapy is a feasible approach to treating nasal carriage of Staphylococcus aureus. Future larger studies should be conducted to determine if photodynamic therapy is equivalent to the standard of care with mupirocin.

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Association of the Urine-to-Plasma Urea Ratio With CKD Progression.

Rationale & objectives The urine-to-plasma ratio of urea ([U/P] was independently associated with disease progression and incident kidney failure. Associations were not significant among those with advanced CKD at baseline.

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Clin J Am Soc Nephrol

A Survey of Environmental Sustainability Practices in Dialysis Facilities in Australia and New Zealand.

Environmental sustainability is not currently prioritized in clinical practice, building design and infrastructure, or management systems in Australian and New Zealand dialysis facilities responding to this survey.

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Symptom Burden before and after Dialysis Initiation in Older Patients.

Symptom burden worsened considerably before and stabilized after dialysis initiation. "Fatigue," "decreased interest in sex," and "difficulty becoming sexually aroused" were considered most burdensome, of which only "fatigue" somewhat improved after dialysis initiation.

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Clin Kidney J

Association between cause of kidney failure and fracture incidence in a national US dialysis population cohort study.

Fracture risk, overall and by fracture site, varies by cause of end-stage kidney disease. Future work to determine underlying pathogenic mechanisms contributing to differential risks might inform more tailored treatment strategies. Our study was limited by lack of data regarding numerous potential confounders or mediators including medications and measures or bone biomarkers.

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Associations of time-dependent changes in phosphorus levels with cardiovascular diseases in patients undergoing hemodialysis: results from the Japan Dialysis Active Vitamin D (J-DAVID) randomized clinical trial.

Our results suggest the importance of maintaining stable phosphorus levels, not only in the normal range, but also without fluctuations, in the risk of cardiovascular events among patients without secondary hyperparathyroidism undergoing maintenance hemodialysis.

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Comparison of four medium cut-off dialyzers.

The results of the four MCO dialyzers evaluated in this study showed good efficiency, with no significant performance differences between them while being completely safe in terms of albumin loss. Likewise, the study confirms the superiority of HDx over high-flux HD with an efficacy close to that of post-dilution HDF.

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Comparison of the profiles of patients defined by age-adapted and fixed threshold CKD criteria: a nationwide, cross-sectional study.

An age-adapted criterion is more closely associated with CVD risk factors and CKD-related diseases compared with fixed threshold criteria.

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Development of crescentic membranoproliferative glomerulonephritis after COVID-19 vaccination.

Recently, numerous publications have reported an association of glomerular diseases with COVID-19 vaccination. Our case presents to the best of our knowledge the first occurrence of possible association of COVID-19 mRNA vaccination with a crescentic form of MPGN.

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Dysnatremia and risk of bloodstream infection in dialysis patients.

Both lower and higher baseline serum sodium levels were associated with a higher rate of subsequent bloodstream infections in dialysis patients. Further studies are needed to determine whether correction of dysnatremia ameliorates infection risk in this population.

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Infectious consequences of the AKI-to-CKD transition.

The AKI-to-CKD transition independently predicts the long-term risk of infection following an episode of AKI.

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Probability of chronic kidney disease and associated risk factors in Chinese adults: a cross-sectional study of 9 million Chinese adults in the Meinian Onehealth screening survey.

CKD is an important public health problem in Chinese adults and this study highlights the need for public health strategies to detect and reduce modifiable risk factors for prevention of CKD.

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Standardization of serum creatinine is essential for accurate use of unbiased estimated GFR equations: evidence from three cohorts matched on renal function.

Significant differences in SCr concentrations between the Minnesota and EKFC cohorts versus CRIC were observed in subjects with the same level of mGFR and equal demographic characteristics and can be explained by the difference in SCr calibration.

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Visit-to-visit variability in blood pressure and kidney disease progression in IgA nephropathy.

SBP variability was significantly associated with kidney disease progression in IgAN.

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J Am Soc Nephrol

Changes in Glomerular Volume, Sclerosis, and Ischemia at 5 Years after Kidney Transplantation: Incidence and Correlation with Late Graft Failure.

Glomerular changes reflect important pathologic processes that predict graft loss. Measuring glomerular changes quantitatively on surveillance biopsies, especially the proportion of ischemic-appearing glomeruli, may enhance the current Banff system and be a useful surrogate end point for clinical intervention trials.

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National Projections for Clinical Implications of Race-Free Creatinine-Based GFR Estimating Equations.

The newly recommended 2021 CKD-EPI creatinine-based eGFR equation may result in substantial changes to recommended care for US patients of al racial and ethnic groups.

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Treatment Effect of the SGLT2 Inhibitor Empagliflozin on Chronic Syndrome of Inappropriate Antidiuresis: Results of a Randomized, Double-Blind, Placebo-Controlled, Crossover Trial.

ClinicalTrials. gov NCT03202667.

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Kidney Int

Analysis from the FIDELITY study examined finerenone use and kidney outcomes in patients with chronic kidney disease and type 2 diabetes.

Adverse events were similar between treatment arms although hyperkalemia, leading to treatment discontinuation, occurred significantly more frequently with finerenone versus placebo (2.4% vs 0.8% and 0.6% vs 0.3% in patients with eGFR under vs 60 ml/min/1.73 m 2 and over, respectively). Thus, finerenone improved kidney outcomes, reduced the hazard of kidney failure, and is well tolerated in patients with chronic kidney disease and type 2 diabetes.

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Clinical phenotypes and long-term outcome of kidney involvement in Erdheim-Chester histiocytosis.

At multivariable analysis, cardiovascular comorbidities were associated with advanced CKD, and age over 50 years with kidney failure/death. Thus, kidney involvement is common in ECD and can lead to CKD or kidney failure despite effective medical therapies or urological procedures.

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Hematopoietic-specific melanocortin 1 receptor signaling protects against nephrotoxic serum nephritis and mediates the beneficial effect of melanocortin therapy.

In contrast, in null splenocytes or macrophages, this effect of MS05 was barely detectable, but was mimicked by an NFB inhibitor. Thus, hematopoietic MC1R signaling attenuates experimental nephritis and mediates the beneficial effect of melanocortin therapy via, in part, regulating the immune response.

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Longitudinal assessment of the health-related quality of life of children and adolescents with chronic kidney disease.

Thus, improvement in HRQoL over time of children on dialysis at baseline was likely to have been driven by their transition from dialysis to transplantation. Additionally, children with CKD stage 1-5 and transplant recipients at baseline had no changes in their disease stage or treatment modality and experienced stable HRQoL over time.

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Uncovering risk factors for kidney injury in children with a solitary functioning kidney.

More research into the etiological role of risk factors will help to translate our findings into individualized care strategies. Thus, our study shows that a significant proportion of children with SFK will develop kidney injury over time.

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Nephrol Dial Transplant

Preparing European Nephrology for the next pandemic: lessons from the ERACODA collaboration.

Aligning different research initiatives, strengthening electronic health records, and involving experts in study design and data analysis will be important in our response to the next pandemic. The European Renal Association may take a leading role in aligning research initiatives via its engagement with other scientific societies, national registries, administrators, and researchers.

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Risk of glomerular diseases, proteinuria and hematuria following mRNA (BNT162b2) and inactivated (CoronaVac) SARS-CoV-2 vaccines.

There was no evidence of increased risks of de novo or relapsing GD with either BNT162b2 or CoronaVac vaccines.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Clin Kidney J

Decreasing microbiota-derived uremic toxins to improve CKD outcomes.

short-chain fatty acids such as butyrate and crotonate) and precursors of uremic toxins. The present review addresses these issues and their relevance for novel therapeutic approaches ranging from dietary interventions to prebiotics, probiotics, synbiotics and postbiotics, to the prevention of the absorption of microbial metabolites and to increased clearance of uremic toxins of bacterial origin through optimized dialysis techniques or blockade of tubular cell transporters.

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Left ventricular dysfunction with preserved ejection fraction: the most common left ventricular disorder in chronic kidney disease patients.

These observations have emerged as this class of drugs has also become the standard of care for many patients with proteinuric CKD, suggesting that there is now hope for addressing the combination of HFpEF and CKD in parallel. In this review we summarize the epidemiology, pathophysiology, diagnostic strategies and treatment of HFpEF with a focus on patients with CKD.

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Peritoneal catheter insertion: combating barriers through policy change.

Based on our research, we found that improving patient selection processes, determining and implementing correct insertion techniques, creating multidisciplinary teams, providing appropriate training and sharing decision making among stakeholders will improve access to PD catheter insertion and facilitate greater uptake of home dialysis. Additionally, on a policy level, we recommend efforts to improve the awareness and feasibility of PD among patients and the healthcare workforce, enhance and promulgate training for clinicians-both surgical and medical-to insert PD catheters and fund personnel, pathways and physical facilities for PD catheter insertion.

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Point-of-care ultrasonography in nephrology comes of age.

We suggest a 'nephro-centric' approach that includes not only ultrasound of the kidney and bladder, but of the heart, lungs and vascular access. We conclude by reviewing some of the sparse data available to guide training initiatives and give suggested next steps for advancing POCUS in nephrology.

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Practical ethical concerns in allocation of pig kidneys to humans.

If trials are successful and receive regulatory approval, pig xenotransplants may become another option for people waiting for a kidney. Before patients are discharged with a functioning xenograft, practical issues with ethical implications remain.

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Repurposing drugs for highly prevalent diseases: pentoxifylline, an old drug and a new opportunity for diabetic kidney disease.

Pentoxifylline is a nonselective phosphodiesterase inhibitor currently indicated for peripheral artery disease. Clinical trials and meta-analyses have shown renoprotection secondary to anti-inflammatory and antifibrotic effects in diabetic patients treated with this old known drug, which makes pentoxifylline a candidate for repurposing in diabetic kidney disease.

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Who killed Bruce Lee? The hyponatraemia hypothesis.

In other words, we propose that the kidney's inability to excrete excess water killed Bruce Lee. In this regard, Lee had multiple risk factors for hyponatraemia that may have included high chronic fluid intake, factors that acutely increase thirst (marijuana) and factors that decrease the ability of the kidneys to excrete water by either promoting secretion of antidiuretic hormone (ADH) or interfering with water excretion mechanisms in kidney tubules: prescription drugs (diuretics, non-steroidal anti-inflammatory drugs, opioids, antiepileptic drugs), alcohol, chronic low solute intake, a past history of acute kidney injury and exercise.

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Kidney Int

A genomic deep field view of hypertension.

This review charts the evolution of our understanding of the genomic basis of hypertension at increasing resolution over the last 5 decades from monogenic causes to polygenic associations, spanning ~30 monogenic rare variants and >1500 single nucleotide variants. Unexpected early wins from blood pressure genomics include deepening of our understanding of the complex causation of hypertension; refinement of causal estimates bidirectionally between blood pressure, risk factors, and outcomes through Mendelian randomization; risk stratification using polygenic risk scores; and opportunities for precision medicine and drug repurposing.

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Nat Rev Nephrol

Gut microbiome studies in CKD: opportunities, pitfalls and therapeutic potential.

As in other fields, the time has come to move towards in-depth quantitative and functional exploration of the patient's gut microbiome by relying on confounder-controlled quantitative microbial profiling, shotgun metagenomics and in vitro simulations of microorganism-microorganism and host-microorganism interactions. This step is crucial to enable the rational selection and monitoring of dietary and biotic intervention strategies that can be deployed as a personalized intervention in CKD.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Clin J Am Soc Nephrol

Short-Term Effects of Potassium Chloride Supplementation on Fibroblast Growth Factor 23 and Phosphate in Chronic Kidney Disease.

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Clin Kidney J

Humoral response to a fourth dose of mRNA vaccine in kidney transplant recipient responders to three doses of mRNA vaccine.

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Increasing but insufficient neutralizing activity against Omicron-BA.1 after a second booster dose of mRNA-1273 vaccine in chronic haemodialysis patients.

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Kidney Int

Viral associations with kidney disease diagnosis and altered kidney metatranscriptome by kidney function.

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Nephrol Dial Transplant

Humoral and cellular responses after a third dose of SARS-CoV-2 mRNA vaccine in patients with glomerular disease.

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Letters&Replies

Letters to the editors and authors’ replies

Am J Kidney Dis

Association Between Particulate Matter Pollution and CKD Mortality by Social Deprivation.

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